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Bhaskar AR, Gad MV, Rathod CM. Impact of COVID Pandemic on the Children with Cerebral Palsy. Indian J Orthop 2022; 56:927-932. [PMID: 35068545 PMCID: PMC8764506 DOI: 10.1007/s43465-021-00591-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The COVID pandemic has been raging across the world for the past 18 months and has severely impacted healthcare and resources. Children with special needs have been adversely affected by the COVID pandemic, due to lack of formal schooling, access to rehabilitation and limited physical and social activity. The aim of this online survey was to understand the effect of the pandemic on the children with Cerebral Palsy (CP). METHODS An online survey was conducted using a nine parts questionnaire comprising 26 questions. Survey included questions pertaining to demographic data, ambulatory status, lack of access to physiotherapy, orthotic adjustment, surgery, deterioration of function, and behaviour. A simple binary answer was sought to cover all social strata of society. RESULTS Responses were received from 101 caregivers who participated in an online questionnaire. 25.7% had no therapy sessions, 74.2% were on therapy of which 23.7% had online sessions. The lockdown restrictions coupled with lack of rehabilitation and orthotic support led to deterioration in physical function in 54 children and worsening of deformity in 34. Changes in behavioural pattern was observed in 45 children. CONCLUSION The survey revealed major disruptions in the care of Children with CP. The parents reported difficulties in managing the child therapy at home. There is always a possibility that the pandemic will result in a lockdown again, and hence our approach toward physical therapy assessment and rehabilitation needs to be towards home-based and family-centred care.
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Affiliation(s)
- Atul R. Bhaskar
- Department of Orthopaedics, Children Orthopaedic Clinic, Andheri, Mumbai, India
| | | | - Chasanal M. Rathod
- grid.511852.aDepartment of Orthopaedics, SRCC Children’s Hospital, Haji Ali, Mumbai, India
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Micheletti S, Galli J, Scaglioni V, Renzetti S, Scarano E, Foresti V, Fazzi E. Promoting Language Skills in Children With Neuromotor and Intellectual Disorders: Telepractice at the Time of SARS-CoV-2. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1866-1879. [PMID: 34232698 DOI: 10.1044/2021_ajslp-20-00222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The aim of this pilot study is to gather preliminary results on the effectiveness of intensive, parent-oriented, telepractice-based intervention to improve language skills in preschool children with neuromotor and intellectual disorders. Method Nine preschool children (M = 63 months, SD = 8.7 months) underwent a telepractice program 4 times a week designed to promote speech, lexical, and syntactic skills. Families were remotely connected from home with the therapists, who controlled the rehabilitation procedures from the hospital. The number of stable phonemes, of understood and repeated words, and of understood and repeated sentences were evaluated as outcome measures 3 months (prebaseline) and 1 week (baseline) before the intervention, immediately after the intervention (T1) and at a 3-month follow-up (T2). Results An increase in the number of stable phonemes was detected after the treatment, even if it was not statistically significant. After the intervention program, there was a significant increase in the number of understood words (ratio T1 vs. baseline: 1.33; 95% CI [1.03, 1.71]) and repeated words (ratio T1 vs. baseline: 1.39; 95% CI [1.00, 1.92]), as well as of understood sentences (ratio T1 vs. baseline: 1.80; 95% CI [1.24, 2.35]) and repeated sentences (ratio T1 vs. baseline: 4.23; 95% CI [1.96, 9.12]). No significant differences were found when comparing all the outcome measures at prebaseline and at baseline. Conclusion An intensive, parent-oriented, telepractice-based intervention has the potential to increase scores of lexical and syntactic tasks in children with neuromotor and intellectual disorders.
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Affiliation(s)
- Serena Micheletti
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Italy
| | - Jessica Galli
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Vera Scaglioni
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Italy
| | - Stefano Renzetti
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Elisa Scarano
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Valentina Foresti
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Elisa Fazzi
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
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Cacioppo M, Bouvier S, Bailly R, Houx L, Lempereur M, Mensah-Gourmel J, Kandalaft C, Varengue R, Chatelin A, Vagnoni J, Vuillerot C, Gautheron V, Dinomais M, Dheilly E, Brochard S, Pons C. Emerging health challenges for children with physical disabilities and their parents during the COVID-19 pandemic: The ECHO French survey. Ann Phys Rehabil Med 2020; 64:101429. [PMID: 32818674 PMCID: PMC7434423 DOI: 10.1016/j.rehab.2020.08.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 08/02/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The daily lives of children with physical disabilities and their families have been significantly affected by the COVID-19 pandemic. The children face health risks, especially mental, behavioral, social and physical risks. OBJECTIVE This study aimed to identify potential healthcare issues relating to the wellbeing of disabled children, continuity of rehabilitation and medical care, and parental concerns during the COVID-19 lockdown. METHODS The Enfant Confinement Handicap besOins (ECHO [child lockdown disability needs]) national survey was developed by a multidisciplinary group and disseminated in France from April 6, 2020 via email and social networks. This online survey was addressed to the parents of children with physical disabilities aged 0 to 18 years. It explored the experiences of children and their families during the lockdown. Information regarding children's wellbeing, rehabilitation and family organization was collected. The first 1000 eligible surveys were analyzed. RESULTS The children (mean [SD] age 9.5 [4.8] years) mostly had cerebral palsy (42%) or neuromuscular diseases (11%). The lockdown had negative effects on morale (44% of children), behaviour (55% of children) and social interactions (55% no contact with other children). Overall, 44% of children stopped physical activities; 76% were educated at home; 22% maintained medical follow-up, and 48% and 27% continued physiotherapy and occupational therapy respectively. For more than 60% of children, parents performed the therapy. The main parental concern was rehabilitation (72%) and their main difficulty was the mental load (50%); parents complained of lack of help and support (60%). CONCLUSIONS This study highlighted substantial effects on the health of children with physical disabilities and loss of opportunity, with a massive interruption of medical follow-up and rehabilitation, during the lockdown. Regular assessment of the health benefit/risk is essential to support families and ensure continuity of care during a pandemic.
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Affiliation(s)
- Marine Cacioppo
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France.
| | - Sandra Bouvier
- Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France; CHRU de Brest, Brest, France
| | - Rodolphe Bailly
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | - Laetitia Houx
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | - Mathieu Lempereur
- Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | | | | | - Roxane Varengue
- Département de neurologie pédiatrique, CHU d'Angers, Angers, France
| | | | - Jacky Vagnoni
- Fédération française des associations d'infirmes moteurs cérébraux, France
| | - Carole Vuillerot
- Service de médecine physique et de réadaptation pédiatrique, hôpital Mère-Enfant, hospices civils de Lyon, 69500 Bron, France; Institut neuromyogène CNRS UMR 5310 inserm U1217, Université de Lyon, Lyon, France
| | - Vincent Gautheron
- Service de médecine physique et de réadaptation pédiatrique, CHU de Saint-Étienne, Saint-Étienne, France; Université de Lyon, UJM Saint-Étienne, laboratoire interuniversitaire de biologie de la motricité, EA7424, 42023, Saint-Étienne, France
| | - Mickael Dinomais
- Service de médecine physique et de réadaptation, CHU d'Angers, Les-Capucins, Angers, France; Laboratoire Angevin de recherche en ingénierie des systèmes (LARIS) EA7315, université d'Angers, Angers, France
| | - Elea Dheilly
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | - Sylvain Brochard
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | - Christelle Pons
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l'information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
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Horwood L, Li P, Mok E, Oskoui M, Shevell M, Constantin E. Behavioral difficulties, sleep problems, and nighttime pain in children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 95:103500. [PMID: 31630025 DOI: 10.1016/j.ridd.2019.103500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 08/26/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) may be at risk of behavioral difficulties. AIMS 1) Determine the prevalence of behavioral difficulties in preschool- and school-aged children with CP and 2) Assess the association between behavioral difficulties and a) sleep problems, b) nighttime pain and c) child characteristics (age, CP phenotype, comorbidities). METHODS AND PROCEDURES Caregivers of 113 children with CP aged 4-12 years [mean (SD) age = 7.4 (2.5) years; 61.9% male] completed the Strengths and Difficulties Questionnaire, Sleep Disturbance Scale for Children and a sleep quality questionnaire to assess child behavior, sleep and nighttime pain, respectively. OUTCOMES AND RESULTS 25.6% of children (17.6% preschool-aged; 29.1% school-aged) had behavioral difficulties. Sleep problems (odds ratio [OR] 9.1, 95% confidence interval [CI] 3.4-24.4) and nighttime pain (OR 4.1, 95% CI 1.5-11.5) were associated with behavioral difficulties. Sleep problems remained significantly associated with behavioral difficulties (adjusted OR 7.5, 95% CI 2.6-21.4) when adjusted for nighttime pain, age and non-ambulatory status. CONCLUSIONS AND IMPLICATIONS Behavioral difficulties were reported in one in four children with CP and were associated with sleep problems and nighttime pain. Identifying and treating behavioral difficulties, sleep problems or nighttime pain is important in the care of children with CP.
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Affiliation(s)
- Linda Horwood
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Patricia Li
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Elise Mok
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Maryam Oskoui
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology/Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael Shevell
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology/Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Evelyn Constantin
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada.
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Hayashi Y, Nishimura E, Shimizu S, Miyano G, Okawada M, Nagae I, Lane GJ, Katsumata K, Yamataka A, Tsuchida A. Sigmoidocolocystoplasty for neurogenic bladder reviewed after 20 years. J Pediatr Surg 2017; 52:2070-2073. [PMID: 29223546 DOI: 10.1016/j.jpedsurg.2017.08.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND/PURPOSE We report the current status of patients who underwent augmentation cystoplasty (AC) at least 20years previously. METHODS Surgical history, incidence of urinary tract infection (UTI) and bladder stones, vesicoureteral reflux (VUR), urine cytology, renal function, a colon cancer tumor marker (carcinoembryonic antigen: CEA), and patient outcomes were assessed. RESULTS Forty patients who underwent AC (mean age: 34.4years; mean follow-up time: 24.3years) were analyzed. Mean age at AC was 11years. Incidence of bladder stones was 30%. There were no incidences of carcinoma after AC, and CEA levels were not increased. Ureteral reimplantation (URI) was performed in 21 patients. URI performed at the same time as AC was successful in 14 cases (93%) and unsuccessful in 1 (7%) because of persistent VUR. UTI developed after AC in only 1 patient (2.5%) with persistent VUR. This patient required unilateral nephrectomy 18years after the AC because of repeated UTIs. Thirty-four patients (85%) were employed, and 4 (10%) were married. Two of the 19 female patients (11%) had experienced pregnancy and delivery. Five patients (13%) had mental disorders. CONCLUSION Ultra long-term follow-up suggests that AC is a safe procedure with manageable sequelae, although some mental health issues remain. TYPE OF STUDY Case series with no comparison group. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Yutaka Hayashi
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Emi Nishimura
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Satoko Shimizu
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Go Miyano
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Manabu Okawada
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Itsuro Nagae
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Geoffrey J Lane
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenji Katsumata
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Atsuyuki Yamataka
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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Proença JP, Quaresma C, Vieira P. Serious games for upper limb rehabilitation: a systematic review. Disabil Rehabil Assist Technol 2017; 13:95-100. [PMID: 28359181 DOI: 10.1080/17483107.2017.1290702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this research is to carry out a systematic review of the use of technological gaming platforms with serious games in the upper limb rehabilitation of patients with neuromotor disorders. Through a systematic review, the first two authors defined the inclusion criteria and extracted the data, resulting in 38 studies collected from B-On, PubMed and Medline. Ninety-two per cent of the selected articles were published since 2010. This review documents 35 different gaming platforms types. Twenty-one of the 38 articles included in this review conducted a clinical trial and of those only eight report improvements in the target population following the use of the games and platforms. This review concludes that a new paradigm is emerging in the rehabilitation field, characterized by the systematic use of technological gaming platforms with serious games in/for rehabilitation. The use of this approach seems to be beneficial. However, to facilitate the full integration of these platforms, it is necessary to conduct more research in this area, explore new approaches and carry out in-depth clinical studies into the benefits of these platforms. Implications for rehabilitation This review states that the use serious games and gaming platforms for upper limb rehabilitation are starting a new paradigm in the rehabilitation. For a full integration of this technologies in the rehabilitation field more studies are needed.
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Affiliation(s)
- João Pedro Proença
- a Department of Physics , Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa , Portugal.,b Technical Resource Center, Alcoitão Centre for Rehabilitation Medicine , Portugal.,c LIBPhys-UNL, Department of Physics, Faculdade de Ciências e Tecnologias , Universidade Nova de Lisboa , Portugal
| | - Cláudia Quaresma
- a Department of Physics , Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa , Portugal.,c LIBPhys-UNL, Department of Physics, Faculdade de Ciências e Tecnologias , Universidade Nova de Lisboa , Portugal
| | - Pedro Vieira
- a Department of Physics , Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa , Portugal
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